The Miracle of Birth

Not yesterdays newborn, but a glorious one nonetheless

Today I’m going to talk to you about the miracle of birth. Well, I don’t actually believe in miracles, but I do think that human reproduction is pretty spectacular. Yesterday I was lucky enough (right choice of words?) to watch a woman here at the Clinic give birth. This is the first (human) birth I’ve seen and it was rather incredible. I did watch a dog squeeze out 11 puppies on my door step last year, but that's not quite the same. I’m so amazed by the concept of reproduction at all that I have to say a big kudos to evolution for sorting out our bodies to enable us to not only grow another human being inside our bellies, but then to squeeze it out as well. And the fact that we are so well evolved that, if needs be, we can do the whole birthing thing on our own, wow. Just wow.

Now, I’m sure I don’t need to go into details here, it was a pretty gross experience, but nowhere near as messy as I had expected, and I have to admit, I was surprised by one or two of the routine things that happen, I thought I knew all about what goes on, but it turns out you learn something new everyday. The mama was a 21 year old Burmese woman, and this was her second child (a little girl by the way, with lots of hair). Anyways, it's been about 9 years since there was a time when someone I know wasn't preggas, and I now have a whole new level of respect for all my amazing friends that have had kids. You guys did good. Real good. 

I am currently writing the 2011 Annual Report for the Clinic, so I thought I’d share some interesting information about our incredible Reproductive Health department here:

Maternal mortality rates are over 1,000 per 100,000 live births in the Eastern Burma conflict zones. This compares to 360 in the rest of Burma and 44 per 100,000 live births in Thailand. This demonstrates the huge need for the safe, free services provided by the MTC reproductive health department.

The department delivers between 3 – 15 babies every day, with the average usually being 7. We offer comprehensive short and long term contraception options for women, including condoms, oral contraceptives, hormonal injections, 3-year hormonal implants, IUD’s and referrals to Mae Sot Hospital for tubal ligation procedures. Our data illustrates that we are now seeing a decrease in the ratio of post-abortion care patients : deliveries. We believe this is a result of our contraception programmes – when given the choice about when and if to have children, women often choose to prevent pregnancies. As a result, fewer unplanned and unwanted pregnancies reduce the incidence of unsafe abortion.

There are many challenges in the RH departments, including an increasing number of premature and low birth weight babies being born. This, in turn, puts pressure on our neonatal unit, which only has the capacity to appropriately care for a small number of premature babies; closely related to this issue is the fact that these babies need to be admitted to the neonatal unit for significant periods of time, hindering the availability of space for new arrivals. The equipment available in the neonatal unit is severely lacking: the department only has two incubators for premature infants; however there are always more than two premature or low birth weight babies at the same time. Four RH-IPD staff have been trained as ultrasound technicians and are able to provide more accurate assessments for women during pregnancy and labour, thus being able to diagnose and reduce many risks faced by a large number of women.

I've seen this every day for a year and I still don't really get the message - use a new one every day, or wash after use so you can use them again next week?

This is just the tip of the iceberg as far as the department goes, we also do a lot to combat the spread of HIV from mother to child for example. So if you’re interested in learning more, check out our RH webpage.

Yay for mama's!

The little things

I’ve been sick this past week. I’ve had the dreaded dengue fever which, as I’m sure you can imagine, is not ideal in this heat. I’m well over the worst now and am currently just suffering from extreme tiredness. I’ve spent the past week in bed, watching tv and movies on my laptop (it’s come to my attention that Carmella Soprano and Dana Scully have awful fashion sense, despite the exciting lives they lead. Such awful unflattering man-ish pants and oversized, shoulder-padded suit jackets, and Carmella, what's with the hair? Dana - you should totally pash up Mulder while you can, don't worry, the truth is out there). Now, let me tell you, sweating through a fever in 38 degree weather, alone and bored is a poor substitute for inhabiting a big comfy couch, a pair of 3XL mens track pants (grey of course) and a million blankets and pillows, and watching Jeremy Kyle and Ricky Lake re-runs. Needless to say it’s been a bit tough not being nursed back to health by someone resembling a mother, who will bring you all kinds of treats and prizes along with significant amounts of sympathy no matter how much of a complaining baby you’re being. However, it’s been really great to see how wonderful my friends are over here, two in particular have been bringing me lots of meals and fruit and generally looking after me. So it hasn’t been all bad. Spending lots of time at home and by myself has led me to think about all the little things that I look forward to having back in my life soon. Side note: I am leaving the border at the end of April and will go and seek my fortune in Melbourne for a time, more on that later. So, in no particular order, here are a few of the things that I have longed for this week:

1. Carpet – a strange thing to desire, it’s true. But lying down on the floor because you got a bit tired standing up isn’t the same when it’s hard shiny tiles, not lush, cosy carpet. 

Creepy outdoor sink

2. Being able to drink the tap water – this has been a big one this week as my kitchen is downstairs and my bedroom is upstairs, so in order to keep sufficiently hydrated (one of the biggest things with dengue) I have to go downstairs all the time to get more of the good stuff, I can’t just drink from the bathroom tap that is a mere 1m from my room.

3. A washing machine – no one here has a washing machine. This means that even doing my washing this week has been a gigantic hassle so I just haven’t done it. Usually I hand wash small things and just take sheets and towels to the laundry lady, but this week, no hand washing or laundry lady, far too much effort. If only I could chuck everything in a machine and press go...

4. Having a functional kitchen – this is a big one. My kitchen consists of one gas ring, my sink is outside in a mosquito infested concrete box (probably where I got the dengue from to begin with). I love to cook, but this past year has been the least cooky of my life and I miss it. Plus, being sick, it’s meant that people have had to bring me pretty much all my meals. No one here really cooks, it’s far cheaper to eat out, which is a lot less glamorous than you think. 

Low grade kitchen

5. Having clean feet – this issue closely relates to point one, above. I’ve been doing a lot of lying in bed. Having tiles through the whole house and incessant dust coming in through the permanently-open windows means that no matter how much you sweep or mop, your feet are always dirty when you walk around the house (fyi – wearing socks is not an option). This dirt is then transferred into your bed pretty quickly, gross.

 

That’s about it. The top five things I’ve been longing for this week (couch, daytime tv, track pants and comfort food aside of course, those ones are the most important, oh except perhaps cheese rolls. Man, I want a million cheese rolls so bad). Hopefully I shall have all these things again soon enough (except perhaps the ever-longed for cheese roll as it is endemic to the lower South Island of NZ)

PS. There are orchids flowering in my garden. I think that's pretty good stuff.

 

 

Living Inside a Heater

For those of you that know me well, you will be aware of the fact that I much prefer wearing no clothes to wearing any clothes. For those that don’t know me that well, this may be a new revelation to you, but don’t go getting any weird ideas, it’s just a well known fact that not wearing clothes is exponentially superior to wearing clothes. The purpose of this little gem of information will become clear soon. 

Depending on your level of knowing me personally, you may also know that I like to complain about things. And the weather seems to be a big point of complaint here in Mae Sot at the moment amongst many people, so I feel it’s only appropriate that I jump on this bandwagon. In the past few weeks, the weather here has changed significantly. When I first got back, it was dry, searingly hot and, as I said back then, like cycling into a hairdryer on full. It then became smoky. Oh so smoky. And the hairdryer became filled with ash and dust, ensuring that any venturing outside that was done left one covered in a fine layer of dusty, ashy grime, itchy eyes and a severly deminished ability to breathe. Then this weekend it rained. For the first time since October. Rain here is not just a casual shower. It’s all or nothing. And the weather has really put on a show in the past few days. There’s been thunder, particularly impressive lightening, and monsoon rain with big, fat, instantly saturating raindrops. This rain solidified my decision to get out of this place before rainy season (more on that another day), I just can’t do it again. 

You may think that with this rain would come some respite from the oppressive heat. Not so my friends; not so. Instead, the thick, wet air has upped the heat index significantly. Now, I have always been particularly interested in weather and temperatures and barometers and such. Thus, I shall tell you about the heat index (courtesy of our good friend wikipedia):

“The heat index or humiture is an index that combines air temperature and relative humidity in an attempt to determine the human-perceived equivalent temperature — how hot it feels. The result is also known as the "felt air temperature" or "apparent temperature". For example, when the temperature is 32 °C (90 °F) with very high humidity, the heat index can be about 41 °C (105 °F).

The human body normally cools itself by perspiration, or sweating, which evaporates and carries heat away from the body. However, when the relative humidity is high, the evaporation rate is reduced, so heat is removed from the body at a lower rate, causing it to retain more heat than it would in dry air.”

Exhibit A

So. This week, we have daily forecasted temperatures of 35-38°C, scattered thunderstorms, and a corresponding heat index of 48 degrees Celsius. Forty-eight. That is a mere two degrees short of 50, and as I am sure you are aware, 50 degrees is half way to boiling point. All this science talk aside, this means that it is real super heaps hot x1,000,000 here. The hair dryer is now on at full blast with a boiling (well, 50% boiling) kettle blowing its steam into the funnel of aforementioned dryer. Hopefully this doesn't cause pulmonary edema or some such.

This brings us full circle. As mentioned above, I am a no-clothes enthusiast. The nights don't even provide an escape from the heat anymore - imagine my dismay when I wake up every morning in my 30ish degree room (yes, I have a thermometer on the wall) and am forced to put on clothes. Well, this dismay would happen anywhere in the world for me, but what makes it most painful here is that I must put on conservative clothing. I refer you to Exhibit A, a photo of me dressed for work this morning. Note the long skirt (side note: this is my amazing Kansas skirt – it is the Sunflower State after all), and the t-shirt (pretty risqué today actually – you can see a lot of chest). Needless to say, these are hot items of clothing to be wearing in nearly 50 degree heat. 

 

It has come to my attention that the hottest places in the world also seem to be the most conservative, demanding the highest fabric:skin ratio. While Thailand itself ins't so conservative, Burma most certainly is. And here in little Burma, shoulders are scandalous, as are legs. Thus, singlets are out, as is anything above the knee. 

I'm too hot to think of a good way to finish this. So I'll just leave you with this: it’s real hot.

Living in the end times